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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Chest Tightness, Dizziness And Nausea?

I am a 64 year old male who has been treated for high blood pressure for about 30 years. I am taking Labetalol, Ramipril, Hydrochlorothiazide, Amlopidene and Chlopodigrel. For the past year and a half I have been having the following symptoms - chest tightness, dizzyness, and nausea. These symptoms occur when I go from a condition of rest and begin to walk. They last 10-15 seconds and then disappear. Once they end I can walk for several miles seldom with a reoccurrence. I ve noticed them when I am on a treadmill and they usually begin almost immediately. While I am having them my heart rate increases rapidly, usually from low 70 s to around 95-100 in that 10-15 second period. My heart rate then begins to decline and at the same time the symptoms disappear. Usually I can continue a 2 mile walk without a reoccurance. The strange thing is I never have these symptoms when my stomach is empty but almost always will have them after eating. I have had 3 stress tests (all negative) and my doctor has me lined up for a heart catheterization next week. Since they only occur on a full or somewhat full stomach could they be caused by something like an ulcer or other stomach related cause? The feeling is very uncomfortable.
Tue, 8 Dec 2015
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Cardiologist 's  Response
Hello , considering that age , hypertension are risk factors of a heart related issue and the Symptoms you describe can many a times referred as anginal pain , it's always wise to rule out underlying cardiac pathology. Also treadmill stress test (TMT) is not the best test when the suspicion of heart issue is high . The sensitivity of TMT is around 75% meaning we may miss 1 in every 4 patients.

However once the cardiac pathology is ruled out either by cardiac perfusion scan or catheterisation , as you truly mentioned a underlying stomach pathology should be suspected particularly some reflux gastritis , the symptom favouring the same is that your pain subsides after the initial walk and later you are able to walk for long time without any significant pain.
A trial of it antacid like imperative 40 mg may be taken for 3 weeks before breakfast.



However as I would again say it's prudent to rule out underlying cardiac if any before considering alternative.
Regards Dr. Priyank Mody
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What Causes Chest Tightness, Dizziness And Nausea?

Hello , considering that age , hypertension are risk factors of a heart related issue and the Symptoms you describe can many a times referred as anginal pain , it s always wise to rule out underlying cardiac pathology. Also treadmill stress test (TMT) is not the best test when the suspicion of heart issue is high . The sensitivity of TMT is around 75% meaning we may miss 1 in every 4 patients. However once the cardiac pathology is ruled out either by cardiac perfusion scan or catheterisation , as you truly mentioned a underlying stomach pathology should be suspected particularly some reflux gastritis , the symptom favouring the same is that your pain subsides after the initial walk and later you are able to walk for long time without any significant pain. A trial of it antacid like imperative 40 mg may be taken for 3 weeks before breakfast. However as I would again say it s prudent to rule out underlying cardiac if any before considering alternative. Regards Dr. Priyank Mody